Before the outbreak of COVID no one had heard of “Excess Deaths”. People die all the time. To understand the impact of the pandemic this “normal death rate” had first to be calculated. They averaged for each month from the four years prior to the outbreak of COVID. They deducted this from the number of deaths each month to calculate the excess of deaths

When the COVID pandemic was declared over we might have expected the number of monthly deaths to return to normal. They have not. In a previous Newsletter we saw how there are still excess deaths. They have persisted in many countries long after the declaration of the end of the pandemic. (Newsletter #142: Life is Not Extending)

There are many reasons suggested for why this is happening. There are sufferers of COVID that have succumbed. The screening for many diseases, especially cancer, did not take place. People are now presenting much more serious symptoms. The medical system was under extreme pressure and may not have recovered. A recent German study suggests another reason. COVID changed the psychology of older people.

Mind over Matter

Ageing is not just a physical phenomenon. Many studies have shown the importance of attitudes. Researchers have looked at individuals’ attitudes to the ageing process. It is part of “Subjective Age”. It can be measured. A typical question might be: “As I get older, things keep getting worse”. Individual data exists over long periods. It shows that as people become less positive their health and wellbeing suffer. They are more likely to get ill and to die. It is a case of "mind over matter". Powerful evidence has come from experiments. Attitudes were manipulated. Nursing home patients were subject to subliminal signals. These improved their attitudes towards ageing. More positive attitudes resulted in them becoming more engaged. They were more mobile and mentally active. (Newsletter # 113 You are as Old as You Feel)

A team in Germany took a huge longitudinal sample. Over 7,300 individuals have been tracked regularly. Their health is monitored every three years. So too are their attitudes to ageing and a self-rating scale of how healthy they feel. The sample was drawn to be representative of the German population. For each individual they could see a slight but steady decline in attitudes to ageing as they aged. As people age biologically it does affect their attitudes.

COVID changed all that. During the pandemic the decline accelerated. They used the same methodology as “excess deaths”. They took the decline in COVID minus the underlying trend. The average COVID drop was a five-fold increase in the rate of decline. People became a lot less positive. Ninety nine percent of people showed the effect. It did vary across individuals. People who had a less positive attitude about their health before COVID suffered the most.

The Psychological COVID Effect.

There are many possible explanations. COVID particularly affects the old rather than the young. Individuals might have lost friends or siblings. This would affect their attitudes. Before the discovery of the vaccines there was genuine fear amongst older people. Social isolation was tough on this group. The digital world came to the rescue of many people whose movement was restricted. People could work from home. “ZOOM” became a way of keeping up with friends and family. We all still remember “You are on mute!” Older people had less infrastructure, smartphones, and computers. They were more likely to be isolated and lonely.

The stereotype impact was higher. The “old” became a homogeneous group of vulnerable people. The media reinforced the weakness of “older people”. The ageist stereotypes of mental and physical frailness were reinforced. There was some backlash against the isolation from the young. In some cases the old were blamed. It was more difficult to deny the stereotypes when in isolation. Life expectancy estimates were revised down and broadcast. Even the friendly neighbour asking if you were alright reinforced the vulnerability.

Will Attitude to Ageing Bounce Back?

There is not enough data yet to understand whether this is a temporary effect. With a three-year cycle in the German study we will have to wait. We know these attitudes are sensitive to events. We would expect the rate of decline to stabilize. Can the trend be reversed, and attitudes become more positive? A smaller study in Switzerland showed the same kinds of declines. In their case there was an uplift as the threat of COVID eased. As vaccines became available and social isolation was removed subjective age measures improved.

COVID did change the lives of older people. Some changes were for the better. Many more people went “online”. They did get Zoom. They did order their groceries and shopping on the web. They did find ways to communicate with friends and families. Many more family WhatsApp groups were formed and still persist. All of which must have reduced loneliness.

Is COVID finished?

It will be many years before the full impact of the pandemic will be understood. There are many explanations for the continued excess deaths. We know that subjective age has a big impact on our health and wellbeing. It is not surprising that our psychology "took a hit" during COVID.